From Video Games To 3D Printing: 5 advancements that are already changing healthcare today for radiologists and clinicians

These game-changers may improve healthcare... and in some cases already are VR-image-skeleton-pulse

The radiologist holds a plastic model of her patient's heart in the palm of her hand, complete with its unique chambers and valves. Her colleague, another clinician, puts on a pair Virtual Reality (VR) goggles to “step inside” the intricate pathways of the patient's body, checking for anything out of the ordinary. Advancements like these are often talked about in the context of gaming and consumer technology, but they are coming closer to reality for healthcare every day. Additive Manufacturing, also known as 3D printing, has been hailed as the fourth industrial revolution because of its potential to improve overall product design, cost, and manufacturing[1]. Already, healthcare tech players like GE Healthcare, which estimates that 70 percent of its imaging systems have additive manufacturing opportunities in the next 10- years, are seeing the results from such advancements for clinicians and patients and planning for more as they bring new innovations to market. Here's what's already happening today for radiologists, researchers and patients today: 1. Role-Playing Video Games Step Inside the Human Body Role playing video games don’t often inspire groundbreaking technology that could revolutionize how doctors visualize human anatomy and diagnose disease. But that’s exactly what happened when GE Healthcare designer Ludovic Avot and medical imaging engineer Yannick Le Berre played Fallout 4, a video game that guides players through post-apocalyptic Boston as a character referred to as the “Sole Survivor.” According to PwC Health Research Institute’s annual report, VR is one of eight technologies that are a growing trend in the next generation of healthcare innovators. As the video game buffs navigated through Fallout 4’s grim world, an odd inspiration struck: What if they used Virtual Reality (VR) video game technology to create a new technology that allows doctors step inside the human body? VR-pulse Ludovic and Yannick decided to find out. They combined VR design tools and other gaming software with detailed 3D information from CT and MRI body scans to build a virtual experience complete with color, texture, light and other features. “We were inspired by the photorealistic rendering techniques of the high-quality games,” Ludovic says. “We tried to exploit the great graphic and interactive potential of the most modern game technologies to show in detail the images obtained by medical tests.” They presented their VR prototype during the Journées Francophones de Radiologie conference in Paris last year, and now the prototype is being tested with customers in France to help doctors study anatomy and diagnose disease. Doctors can use VR headsets like the Oculus Rift® to “enter” a specific part of the body to examine any anomalies, such as polyps, tumors and lesions, or investigate injuries. “This tool can be a new way for radiologists to observe complex clinical images,” says Ludovic. “It allows them to manipulate and interact with images and offers more extensive zoom, which may prove useful in specific cases, such as the study of the heart of children. The shadowing and the lightning greatly helps to understand the shapes of anatomical structures.” Ludovic and Yannick also expect demand to increase for their VR technology, not only for diagnostics but also to practice procedures before surgeries, double check results post-surgery, and to collaborate on cases. “We would like to use the multiplayer capabilities to allow multiple users to review the same case,” Ludovic says. “It’s a video game that all doctors will want to play.” virtual reality dinamic 2. Visualization and printing of specific organs and systems As an AW advanced visualization and application specialist, Adeline Digard's job is to help clinicians see clinical images in a new way. She helped developed a 3D printing technique that allows doctors to use GE Healthcare’s AW Workstation to export images to a 3D printer. This year, much of her work has centered around showing radiologists, surgeons and other clinicians how easy it is to print anatomical models from AW Workstation, an asset-management program for clinical images from CT, MR, PET and more. “We’re showing the customer that the anatomical part we showed in virtual reality is now in print,” she says. “The customer will see exactly what they can do with 3D printing.” After a patient is scanned, Clinicians use GE Healthcare’s AW advanced visualization software to review the images, segment organs or regions of the body, and use The Volume Viewer application to create 3D renderings of the affected area. AW’s advanced visualization application accelerates the workflow necessary to create these models – and are 20% faster than previous AW products. Until recently, if clinicians wanted a 3D print of the rendering, they would rely on third parties to export the renderings to a 3D printer-friendly file. According to some clinicians, this could take days depending on the complexity of the models. In 2016, GE Healthcare introduced a software that converts a 3D segmented image to an STL file readable by 3D printers, right from any VolumeShare 7 platform, which can cut down the processing time significantly. In the last few years, 3D printing has become a staple topic in healthcare trends. A market research report by IndustryARC projects the 3D-printing healthcare market is expected to grow by 18 percent annually until 2020. And the PwC Health Research Institute’s annual report lists 3D printing as one of the growing trends in healthcare innovation. Adeline says that her new technology was inspired by clinicians. “The request for this tool has come directly from our customers, especially for pediatrics because it’s very difficult to explain to parents what their children have. It’s easier to show them a 3D model instead of an image.” Despite requests for this technology, Adeline says many physicians are still unsure how to incorporate 3D printing in their practices. They often have a misconception that it’s difficult to use. “We provide a very simple solution,” she says. “You can easily do everything with 3D printing – make a bone, a finger, a hand but also a heart, an aorta or any arteries.” Now that the first system is developed, she anticipates that more versions will push the technology even further. “We are the beginning of this story,” she says. “In two or three years, we are going to create even more innovations.” 3. Surgical planning, education and helping visually impaired patients "see" their babies Without the gift of sight, pregnancy can be a very different experience. Ana Paula Silveira and her husband, Alvaro Zermiani, are both visually impaired, and thought they would have to guess what their baby would look like. Dr. Heron Werner, a Brazilian obstetrician and gynecologist, helped this mother-to-be to ‘see’ her baby, creating 3D printed models from ultrasound images she could touch and feel. “There was a 3D printing project going on in 2007, where CT (Computed Tomography) was being used to image fossils and mummies at the National Museum of Brazil,” he recalled. “I thought, ‘why not use this technology to print fetuses?”

GIF_3d_printing_PULSE“Now I do an ultrasound of the baby, then use the data from the exam to make a file that’s compatible with 3D printers,” The main purpose of Dr. Werner’s work is to take care of expecting moms and monitor the baby’s development using ultrasound. But he also realized that doing the 3D printing from the exam could be a great way to help blind parents to ‘see’ their baby before birth and have the same life-changing experience all parents have when seeing their new child for the first time.

GE Healthcare’s Voluson E10 is the first ultrasound system in the OB/GYN field to have a print capability directly built into the system. With this, doctors can help parents better understand defects such as cleft lip, abnormal extremities, or abdominal wall defects. In some cases, 3D printing can enhance discussions around surgical planning and for education purposes.

“For people like us, who are visually impaired, this was a real gift,” said Alvaro. “Holding the plaster cast of Davi’s face, feeling his features and how similar he was to Ana and me… I’ll keep that experience for life.” 4. Advanced Manufacturing Lowers Costs and Brings Innovations to Market Faster It all started when two engineers had an idea. In June 2016, Andreas Marcstrom and Klas Marteleur were working as part of GE Healthcare Life Sciences’ Research and Development team in Uppsala, Sweden, when they began to envision a new way to approach 3D printing in the healthcare industry. Some researchers and physicians were already using 3D technologies to help plan surgeries and even replace body parts with 3D printed components, but Marcstrom and Marteleur saw an opportunity to bring these concepts to every facet of healthcare, even earlier in the process, before they reached the patient.
[video width="1920" height="1080" mp4=""][/video] 3D printing is a multi-step process. Shown: The steps when using an M2 metal printer.
Inspired by the idea of Additive Manufacturing, also known as industrial 3D printing, and how it can improve the supply chain and product design in healthcare, they envisioned a space where engineers and manufacturers could collaborate under the same roof to develop and produce parts for healthcare equipment, especially for the booming biopharma industry. These parts, as a result of how they were produced, would get to the researchers, biopharmaceutical makers, labs and hospitals faster and last longer. In May 2017, Marcstrom and Marteleur ordered their first 3D printer to their GE Healthcare lab in Uppsala Sweden. Only a year and half later, after they initially imagined a space to test 3D printing for the industry, on October 3, GE Healthcare’s first Innovative Design and Advanced Manufacturing Technology Center in Europe officially opened in the same spot where this printer first arrived. The new center brings together two traditionally separated groups: the research and development teams behind industry-leading new ideas and the manufacturing teams responsible for realizing those innovations. Marcstrom and Marteleur say this unique partnership gives them an exceptional opportunity to create a new way of approaching 3D printing.“We are exploring opportunities where additive manufacturing can bring cost savings and technical improvements to our supply chain and products,” explains Marcstrom, Manager of Additive Engineering at GE Healthcare’s Uppsala site. “We believe having design and advanced manufacturing expertise together with a range of equipment ‘under one roof’ will make a difference in how quickly we can bring new products to market in the future.” The new center uses the latest technologies, including 3D printing and robotics, to simplify production processes for GE Healthcare and its customers, helping them accelerate the launch of innovative products for the healthcare industry.
[caption id="attachment_10701" align="aligncenter" width="690"] Ljung operating a collaborative robot, or “cobot”, that can increase line efficiency in a factory.[/caption]
True to the engineers’ original vision, the center also combines advanced manufacturing technology such as metal and polymer printers and collaborative robots, or “cobots”, with traditional machining equipment. Advanced manufacturing engineers work with Research and Development (R&D) teams in Uppsala to ensure additive expertise is available from the start of product design. Teams then design, test and install 3D-printed parts for GE Healthcare products and in collaboration with customers. Additive manufacturing will help drive new levels of productivity for GE and its customers. It combines cutting-edge technology and new manufacturing processes to lower cost and accelerate the innovation, speed and performance of industrial products.“We’re making the impossible, possible,” says Klas Marteleur, Principle Engineer on the Additive team. “We’re doing it faster, with less materials so it’s environmentally friendly, and with a lower cost.” 5. 3D Printing Meets the Booming Biopharma Industry Biopharmaceuticals are the world’s fastest-growing class of medicines -of the top ten therapeutics on the market today by revenue, seven are biopharmaceuticals – but the development and manufacturing processes for these therapies are demanding and complicated. 3D printing may be one piece of solving this challenge — In the GE Healthcare Additive Manufacturing Technology center, the team is also working with the biotechnology company Amgen to test the performance of a 3D printed chromatography column, used in the complex process to develop biopharmaceuticals, a range of drugs used to treat diseases including cancer and immune diseases. The 3D printed column has been custom-designed and is now being tested to see if it can be used in Amgen’s research to help develop improved processes for the purification stage of biopharmaceutical production.Doing so might mean drugs that are used against some of the deadliest diseases, in turn, reach the market and patients faster.The process starts by sending a computer-aided design (CAD) model to a 3D printer, which prints layer upon layer of material to create everything from machine components to human anatomy. Once a part is printed, it goes through post-processing to be cleaned and polished. Finally, engineers test its strength and functionality through quality control.
[caption id="attachment_10706" align="aligncenter" width="690"] Additive manufacturing is more flexible than traditional manufacturing, allowing for product designs that could not be achieved before. Here a 3D-printed gas manifold for a bioprocessing technology.[/caption] This process is less wasteful than traditional manufacturing, where material is machined off from a material blank to make the final product. It’s also much more flexible than traditional manufacturing, allowing for product designs that could not be achieved before. And it’s already improving manufacturing efficiency in the healthcare industry: Across supply chains, single 3D printed parts are replacing multiple, complex, expensive parts, with a host of technical improvements, waste reduction and cost savings.
For example, a 3D printed part can combine many parts into one and a cobot deployed in a factory can increase line efficiency. Benefits such as this are needed for example in the biopharmaceutical industry where manufacturing equipment can be complex and made up of hundreds different parts.   [1] Maynard, Andrew D. “Navigating the fourth industrial revolution.” Nature nanotechnology 10.12 (2015): 1005. * This article refers to a technology in development that represents ongoing research and development efforts. This technology is not a product and may never become part of a product. It is not for sale and it is not cleared or approved by the U.S. Food and Drug Administration or any other global regulator for commercial availability.